Efficacy of Simultaneous Application of Repetitive Transcranial Magnetic Stimulation and Virtual Reality Training on Sensory-motor and Cognitive Deficits among Stroke Patients: A Protocol for a Randomised Controlled Trial
Bibliographic record
Abstract
Introduction: Stroke is a significant contributor to chronic impairment on a global scale, impacting millions of individuals each year. Despite the progress made in the field of stroke management, individuals frequently experience enduring sensorimotor and cognitive impairments that have a substantial influence on their quality of life and ability to live independently. Need of the study: Virtual Reality Training (VRT) consists of rigorous, repetitive sessions that promote cerebral-hemispheric integration through the creation of a stimulating environment that combines sensory and motor functions. It is anticipated that VRT and Transcranial Magnetic Stimulation (TMS) will stimulate the affected hemisphere while inhibiting the unaffected hemisphere. Voluntary movement is also crucial for interhemispheric interaction; therefore, the present research employs VRT for physical movements while stimulating across multiple regions of the brain. Aim: To investigate the combined efficacy of Repetitive Transcranial Magnetic Stimulation (rTMS) and Virtual Reality Training for sensorimotor and cognitive deficits among stroke patients. Materials and Methods: The present study will be a singleblind, prospective, randomised controlled trial recruiting 69 patients with unilateral stroke from Jaypee Hospital Noida, Uttar Pradesh, India for a continuous period of one year from July 2023 to June 2024 and will be allocated through block randomisation to one of the three treatment groups as per the inclusion and exclusion criteria. Group 1- Simultaneous repetitive TMS (rTMS) and VRT, Group 2- rTMS combined with Sham VRT, and Group 3- VRT protocol combined with Sham Stimulation. Fugl Meyer Assessment (FMA), Montreal Cognitive Assessment (MOCA), National Institutes of Health Stroke Scale (NIHSS), and Addenbrooke’s Cognitive Examination III (ACE III) will be measured at baseline and at the end of the fourth week.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.028 | 0.021 |
| Meta-epidemiology (narrow) | 0.005 | 0.002 |
| Meta-epidemiology (broad) | 0.014 | 0.006 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.002 | 0.004 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.004 | 0.002 |
| Research integrity | 0.007 | 0.006 |
| Insufficient payload (model declined to judge) | 0.039 | 0.006 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".